Partial epiphyseal arrest and supplemental fixation for progressive correction of congenital spinal deformity.

Epiphyseodesis of the vertebral bodies on the convex side of the curve combined with subcutaneous distraction instrumentation on the concave Figs. 1-A through l-E: Case I. Figs. I-A and I-B: The original radiographic appearance of the spine in 1974 and after four and one-half years of bracing with an underarm orthosis. Progression of the curvature from 30 to 37 degrees is shown. Fig . I -C: The radiographic appearance of the spine after combined anterior and posterior convex epiphyseodesis and concave subcutaneous distraction instrumentation. side was carried out in one patient with congenital scoliosis and in one with congenital lordosis. The technique has proved beneficial not only in arresting progression of the curvature but also in producing continued improvement of the deformity by growth on the * 420 Delaware Street SE. ,Minneapolis, Minnesota 55455. The management of progressive congenital spinal deformity has proved to be a challenging although, at times, a disheartening experience for the orthopaedic surgeon. Orthotic management is at best a temporizing treatment, and surgical arthrodesis is the mainstay of management. Correction of congenital spinal deformity, particularly congenital kyphosis, is also associated with a higher risk